CZ83694A3 - Device for treating patients with derangement of keeping the body in position and movement activity - Google Patents

Abstract

The device for treating patients with disturbances of posture and motor activity comprises holding means (1) for shoulder, pelvis, knee, feet, elbows, hands and fingers which are mutually connected by fixing elements. The fixing elements are designed as resilient tensile elements (2) and arranged on the body surface of the patient in antagonistic pairs according to the principle of the anatomical position of the skeletal muscles. Each tensile element (2) is connected to two holding means (1) and comprises a tension controller (3) for tensioning thereof, which is located between the tensile element (2) and one of the holding means (1) via a clasp (5).

Description

The invention relates to a device for the non-surgical treatment of a support and locomotive apparatus in neurological diseases, and more particularly to a device for the treatment of patients with impaired posture and physical activity disorders.

BACKGROUND OF THE INVENTION

The number of neurologic patients with impaired function of the musculoskeletal system is currently enormous, and for a number of reasons, cerebral palsy has a tendency to spread in many countries around the world.

The up-to-date treatment of locomotor functions in persons with cerebral palsy is determined by both the number of patients and the imperfections of the current treatment methods.

A number of methods and devices are currently known for treating patients with impaired posture and physical activity.

A method of treating patients with impaired posture and movement activity is known (AM Žuravlev et al. Surgical Correction of Posture and Walking in Cerebral Palsy, 1966, Ajastan (Yerevan), p. 90-91), which consists in gradual plastering and subsequent rigid fixation of limb and torso position with altered posture. The disadvantage of this method is the immobility of the patient, which may lead to muscle atrophy, induction of convulsions and an increase in hypertensive syndrome due to an increase in pathological muscle synergies.

Another drawback of this method is the long treatment time of the patients, for four to six months.

Also known is a device for the treatment of patients with impaired posture and physical activity (FR, A, 2120500), which has the form of a jumpsuit in which resilient expandable tubes are incorporated to provide rigidity.

The drawback of this device is that it is designed to maintain a certain position of the patient's body, thereby limiting the suitability of use of the device. Moreover, this device does not solve the problem of training the patient's muscular system, which can lead to severe impairments of his / her body functions.

Also known is a device for the treatment of patients with impaired posture and physical activity (FR, A, 2252836), which comprises two paddles that are placed between the patient's thighs, each of which paddles are attached to the respective thigh and connected to a mechanical system. .

The disadvantage of this device is that it only corrects the incorrect position of the thighs, knee joints and legs. In addition, the device is cumbersome and, as a result, its therapeutic use is quite problematic.

Another known device for treating patients with impaired posture and physical activity (SU, A, 1528483) comprises thoracic, pelvic and foot supports, and fixation elements for interconnecting these supports.

The fixing elements are designed as telescopic supports connecting the foot supports and the pelvic supports, as well as a rod, one end of which is rigidly connected to the pelvis support. A two-way movable pulley is mounted on the rod and is rigidly connected to the chest support. Two brackets are fixed to the pelvic support, the free ends of which are connected to springs slidably mounted on telescopic supports.

In the vertical position of the body, the pulley ensures a light reclining effect on the entire spine, while the chest support provides support for the upper torso. When bending the hull, the pulley rolls along the surface of the rod according to the bending angle and assumes an optimum position while the springs transfer the force to the rod. In this way, the weight of the inclined part of the torso is compensated and the muscular system and spine are lightened.

A drawback of the above device is that it is intended only for the treatment of the spine by relieving it. In addition, the use of this device may result in reduced mobility of the patient, with consequent muscle atrophy and consequent decrease in antigravity muscle activity. The treatment process using this device is lengthy.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a physiologically normal stereotype for body posture and movement.

SUMMARY OF THE INVENTION It is an object of the present invention to provide a device for treating patients with impaired posture and movement activity, in which the fixation elements have a structure for joining the supports which allows to fix and secure the patient's torso and limbs in a position close to physiological para4 meters. the patient retained the possibility to perform energy-loaded movements with amplitudes that are characteristic of the patient.

This object is achieved in a device for treating patients suffering from a posture or physical activity disorder, comprising pelvic and foot supports to be fastened to the patient's body and limbs, which are connected to each other by means of fixation elements according to the invention. designed as resilient traction members intended to be placed on the top of the patient's body according to the anatomical position of the skeletal muscle system, each traction member being connected to two surgeries.

The device according to the invention allows the joints to be fixed in the desired position while producing a force which promotes bending, tensioning, rotation, attraction and withdrawal of the limbs and torso.

A preferred embodiment of the device according to the invention comprises additional shoulder, knee, elbow, hand and finger supports.

Such a variant of the invention allows the fixation of virtually all the torso and limb joints of the patient in a predetermined position, while ensuring that the patient can perform energetically loaded movements with acceptable amplitudes.

It is expedient if the device comprises voltage regulators of elastic tension elements, each of which is arranged between a corresponding tension element and one of the supports.

By inserting the voltage regulators into this device, it is possible to vary and individually adjust the force that the traction elements exert on the bone and muscular system, which increases the effectiveness of the treatment.

The use of the device according to the invention makes it possible to replace the static (passive) corrections of the trunk and limb pathological positions by a functional (active) correction, to reshape the earlier pathological stereotype of posture and movements in the central nervous system and periphery. create new control and excitation systems while maintaining brain integrity. In addition, the effect of the device according to the invention on the patient's organism is that the correction of the supporting and locomotor apparatus and the energy load of the movements in the new position of the limbs and trunk lead to central brain structures activation. as well as the motor apparatus of the manner of speaking. The use of the device according to the invention makes it possible to create a stereotype of posture and movements that is close to physiological.

Overview of the drawings

An exemplary embodiment of the device according to the invention is shown in the drawing, wherein Fig. 1 is a front view of the device, Fig. 2 is a side view, and Fig. 3 is a rear view.

DETAILED DESCRIPTION OF THE INVENTION

The device comprises abutments 1 which are intended to be fastened in the region of the patient's arms, elbows, hands, hip, knees, legs and toes. The abutments 1 are connected to each other by means of fixing elements, which are designed as elastic tension elements 2, which can connect both adjoining and non-adjacent abutments

1. The pulling elements 2 are connected to the abutments 1 so that they are arranged on the surface of the patient's body in antagonistic pairs based on the anatomical position of the skeletal muscles. Each tension element 2 is provided with a voltage regulator 3 which connects the tension element 2 to one of the supports 1.

Each regulator 3 is in the form of a strip 4, one end of which is connected to the pulling element 2 and the other end of which is clamped in a lock 5 which is fastened to one of the supports 1.

The controller 3 may be of any design, fulfilling the same purpose and function.

The abutments 1 may be made of any material with a minimum degree of tension, for example fabric, leather, plastic and the like.

The device according to the invention is used as follows:

With regard to the patient's condition and individual approach, a device of the appropriate size is selected, clamped onto the patient's body and the tension elements are tensioned

2, which corrects the position of those parts of the body to be treated. The tension elements 2 are tensioned by means of the regulators 2a in the necessary tensioned state by means of locks 5. Adjustment of the tension elements 2 is carried out so as to achieve a new position of the torso and limbs corresponding to the physiological position. an amplitude that is close to the maximum amplitude in this patient. The tension of the tension elements 2 increases at least until a load of the muscle group corresponding to the respective movement is reached. This makes the device ready for use.

In this way, the support and dynamic structure (functional corset) is achieved with the device according to the invention and the patient is prepared to perform the movements.

Depending on their condition and individual traits, the patient uses this device for up to 12 hours a day. The treatment cycle lasts 15 to 30 days.

The tension elements 2 arranged on the surface of the patient's body in antagonistic pairs according to the principle of the anatomical distribution of the skeletal muscles with respect to the extremities ensure during the use of this device all kinds of movement of the patient. During treatment, a dosage increase of the tension elements of the pulling elements 2 is performed. As the patient adapts to the corrective action of the device, the correction force gradually increases while maintaining a sense of comfort under increased stress.

During the healing process a new stereotype of movement control is created. In addition, the physiological position is predominant, leading to a reduction in pathological muscle synergies and an increase in motor activity. At the same time, posture can be corrected in those cases that cannot be treated by other means of correction.

The device may be supplemented by a coverall which is put on the patient and overlaps with the device according to the invention, leaving openings in the cover allowing access to the controllers 3.

Example 1

Sick B.K., 17 years. Diagnosis: cerebral polio found at the age of six months. At the time of application of the device according to the invention, the patient was affected by paralysis in the form of spastic diplegia. A triple bend in the lower limbs was found, complicated by ankle joint contractures, internal thigh rotation, uncompensated body inclination forward, difficult mobility, pathological gait, equino-valgus deformation of both legs, so-called rocking, internal rotation of both arms, limited motor hands and fingers. Intellect preserved, phrase language. A high level of psychological motivation for medical rehabilitation has been reported. Previously, drug treatment and physical therapy would be performed, and correction would be done with plaster dressings and longet. However, the treatment performed in this way produced only a transient effect.

The patient was treated for one month with a device according to the invention for 2 to 3 hours daily.

The induced load in the patient was associated with an uncomfortable feeling in the first seven days, after which the perception of the load disappeared and adaptation occurred. However, in the first five days, the pathological position of the hull reappeared once the load was removed. However, on the tenth day of the treatment procedure, a stable result has already been shown in the form of complete elimination of pathological posture, overcoming the bent position of the lower limbs, improving walking, improving thighs forward movement and increasing walking speed. After the tenth day, the patient began to walk upright. In addition, on the tenth day of treatment, the patient's pronatory position of the arms significantly weakened and the movement of the hands and fingers improved. The patient was released after 30 days, with a significant improvement in physical and static functions.

The following table shows the clinical effects of the use of the device according to the invention in a group of patients with residual late stage cerebral palsy. (Age of patients 15 to 20 years, number of treatments 16 to 22 in one month).

Table

Pos. Form No. Disease Number sick Dynamics of regeneration process healing Evaluation result five point running 1 2 3 4 5

Diplegia spastica

1. Normalization (not always complete) of major pathological muscle synergies affecting triple leg flexion and arm flexion. Extension of the step length, correct formation of step reflection. 4-3

2. Torsion and torso weakening. Reduce the intensity of the front swing.

3. Disintegration of pathological synergy in the shoulder area. Increased hand and finger handling capabilities.

4. Gradual improvement of pronunciation while speaking.

3

Hyperkinetic form

1. Start walking without support.

Torsion hyperkinesis of the muscles of the neck and torso still persists.

2. The intensity of hyperkinesia decreases after 10 to 15 applications. Longer walking is also possible, but without the accompanying movement of the arms.

3. Speech improvement (speech becomes comprehensible to the environment).

There is a movement of hands for the purpose of self-operation. 4-3

Cerebral- 2 1.

form

2.

3.

Hemipare- 2 1.

form

2.

3.

Walking independently at a distance of 200 to 300 m (starting condition - no walking) 5

Reduction of cerebral symptoms (hypermetry, dysmetry, trunk and limb ataxia).

Reducing speech chanting.

Clear speech intelligibility.

Improvement of existing movement functions.

Reduce fatigue while walking, walking over longer distances.

Improving the handling ability of the paretic arm. 3 parental polio.

As can be seen from the above table, using the device according to the invention, the best result was obtained in the cerebral form of the disease, the least effect is in the hemiparetic form of cere

Example 2

Ill X - age 40 years. Diagnosis: Spinal cord disease with partial conduction disorder (caisson disease).

The patient underwent a cure using the device of the invention. The treatment improved the gait parameters: muscle work synchronized, gait speed increased and fatigue reduced.

Industrial applicability

The device according to the invention can be used for the treatment of persons suffering from cerebral palsy, as well as in insects associated with mobility disorders and traumatic spinal cord injury.

The invention is most effective in treating cerebral palsy.

The solution according to the invention is also applicable to insects with movement disorders and to traumatic spinal cord injuries.

In addition, the invention can be used for correcting the posture of a human as well as for sporting exercises.

Claims (3)

A device for treating patients with impaired posture and movement activity, comprising pelvic and foot supports for attachment to a patient's body and limbs and connected to each other by means of fixation elements, characterized in that the fixation elements are elastic tension elements (2) for depositing on the surface of the patient's body according to the anatomical position of the skeletal muscle system, each tension element (2) being connected to two surgeries (1). Device according to claim 1, characterized in that it comprises additional shoulder, knee, elbow, hand and finger supports (1). Device according to claims 1 and 2, characterized in that it comprises tension regulators (3) of tension members (2), each of which is arranged between a corresponding tension member (2) and one of the supports (1).